A nurse is providing discharge instructions to a parent and his school-age child who has juvenile idiopathic arthritis. Which of the following
instructions should the nurse include?
Encourage the child to take a 45 min nap daily
Administer prednisone on an alternate day schedule
Apply cool compresses for 20 min every hour
Allow the child to stay at home on days when her joints are painful
The Correct Answer is B
Choice A reason: Encouraging the child to take a 45 min nap daily is not a helpful instruction, as it may interfere with the child's normal sleep pattern and school schedule. The child may benefit from regular rest periods throughout the day, but not necessarily a long nap. ⁵
Choice B reason: Administering prednisone on an alternate day schedule is a helpful instruction, as it is a common way of prescribing corticosteroids for children with juvenile idiopathic arthritis. Corticosteroids are used to reduce inflammation and control symptoms, but they have many side effects, such as growth suppression, weight gain, and osteoporosis. Giving the medication every other day may reduce some of these side effects and improve compliance. ⁶
Choice C reason: Applying cool compresses for 20 min every hour is not a helpful instruction, as it may cause skin damage and discomfort. Cool compresses may be useful for acute inflammation, but not for chronic arthritis. Warm compresses or baths may be more soothing and beneficial for the child's joints. ⁷
Choice D reason: Allowing the child to stay at home on days when her joints are painful is not a helpful instruction, as it may lead to social isolation, academic difficulties, and reduced physical activity. The child should be encouraged to attend school and participate in activities as much as possible, with appropriate accommodations and modifications if needed. The child may also benefit from physical therapy, occupational therapy, and pain management strategies. ⁸
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Rice is a suitable food choice for a child who has celiac disease, as it is a gluten-free grain that does not cause inflammation or damage to the small intestine. Rice can provide carbohydrates, fiber, and vitamins for the child's nutrition.
Choice B reason: Rye is not a good food choice for a child who has celiac disease, as it is a gluten-containing grain that can trigger an immune response and harm the small intestine. Rye can cause symptoms such as diarrhea, abdominal pain, bloating, and weight loss in the child.
Choice C reason: Wheat is not a good food choice for a child who has celiac disease, as it is a gluten-containing grain that can trigger an immune response and harm the small intestine. Wheat can cause symptoms such as diarrhea, abdominal pain, bloating, and weight loss in the child.
Choice D reason: Barley is not a good food choice for a child who has celiac disease, as it is a gluten-containing grain that can trigger an immune response and harm the small intestine. Barley can cause symptoms such as diarrhea, abdominal pain, bloating, and weight loss in the child.
Correct Answer is A
Explanation
Choice A reason: Your baby will receive a hepatitis B vaccine prior to discharge is correct, as this is the recommended schedule for the first dose of the hepatitis B vaccine for all newborns, regardless of maternal hepatitis B status.
Choice B reason: Your baby will have the first diphtheria, tetanus, pertussis vaccine at the 2 week well-baby visit is incorrect, as this is too early for the first dose of the DTaP vaccine. The first dose of the DTaP vaccine should be given at 2 months of age.
Choice C reason: Your baby should receive the pneumococcal conjugate vaccine on his first birthday is incorrect, as this is too late for the first dose of the PCV13 vaccine. The first dose of the PCV13 vaccine should be given at 2 months of age, followed by three more doses at 4, 6, and 12-15 months of age.
Choice D reason: Your baby should receive the measles, mumps, rubella vaccine at 6 months is incorrect, as this is too early for the first dose of the MMR vaccine. The first dose of the MMR vaccine should be given at 12-15 months of age, followed by a second dose at 4-6 years of age.
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